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General NPI Number Information
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NPI Number | 1164306700
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Entity Type | Individual
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Provider Name | LA KENDA CROSBY CERTIFIED PHLEBOTOMY
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Gender | Female
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 2715 MORGAN DR APT 21
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City | SAN RAMON
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State | CA
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Zip | 94583-2293
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Country | US
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Telephone | 209-879-1096
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6074
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City | OAKLAND
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State | CA
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Zip | 94603-0074
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Country | US
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Telephone | 209-879-1096
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | CPT-00072950
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | CPT-00072950
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License Number State | CA
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